Common use of Extra Continuation for Disabled Qualified Continuees Clause in Contracts

Extra Continuation for Disabled Qualified Continuees. If a former Employee who is a Qualified Continuee is determined to be disabled under Title II or Title XVI of the United States Social Security Act on the date his or her group health benefits would otherwise end due to the termination of employment or reduction of work hours to fewer than 25 hours per week or during the first 60 days of continuation coverage, he or she may elect to extend his or her 18-month continuation period for himself or herself and any Dependents who are Qualified Continuees for up to an extra 11 months. To elect the extra 11 months of continuation, the Qualified Continuee must give the [Carrier] written proof of Social Security's determination of his or her disability before the earlier of: the end of the 18 month continuation period; and 60 days after the date the Qualified Continuee is determined to be disabled. If, during this extra 11 month continuation period, the Qualified Continuee is determined to be no longer disabled under the Social Security Act, he or she must notify the [Carrier] within 31 days of such determination, and continuation will end, as explained in the When Continuation Ends section. An additional 50% of the total premium charge also may be required from the Qualified Continuee by the Employer during this extra 11 month continuation period. If An Employee Dies While Insured If an Employee dies while insured, any Qualified Continuee whose group health benefits would otherwise end may elect to continue such benefits. The continuation can last for up to 36 months, subject to the When Continuation Ends section. If An Employee's Marriage or Civil Union [or Domestic Partnership] Ends If an Employee's marriage ends due to legal divorce or legal separation or dissolution of the civil union [or termination of a domestic partnership], any Qualified Continuee whose group health benefits would otherwise end may elect to continue such benefits. The continuation can last for up to 36 months, subject to the When Continuation Ends section. If A Dependent Loses Eligibility If a Dependent child's group health benefits end due to his or her loss of dependent eligibility as defined in this Contract, other than the Employee's coverage ending, he or she may elect to continue such benefits for up to 36 months, subject to When Continuation Ends. The Employer's Responsibilities Upon loss of coverage due to termination of employment or reduction in work hours, the Employer must notify the former employee in writing, of: his or her right to continue this Contract's group health benefits; the monthly premium he or she must pay to continue such benefits; and the times and manner in which such monthly payments must be made. Upon being advised of the death of the Employee, divorce, dissolution of the civil union, [termination of domestic partnership] or Dependent child’s loss of eligibility, the Employer should notify the Qualified Continuee in writing, of: his or her right to continue this Contract's group health benefits; the monthly premium he or she must pay to continue such benefits; and the times and manner in which such monthly payments must be made.

Appears in 10 contracts

Samples: www.state.nj.us, www.nj.gov, www.nj.gov

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Extra Continuation for Disabled Qualified Continuees. If a former Employee who is a Qualified Continuee is determined to be disabled under Title II or Title XVI of the United States Social Security Act on the date his or her group health benefits would otherwise end due to the Employee's termination of employment or reduction of work hours to fewer than 25 hours per week or during the first 60 days of continuation coverage, he or she and any Qualified Continuee who is not disabled may elect to extend his or her 18-18 month continuation period for himself or herself and any Dependents who are Qualified Continuees above for up to an extra 11 months. To elect the extra 11 months of continuation, the Qualified Continuee or other person acting on his or her behalf must give the [Carrier] Employer written proof of Social Security's determination of his or her disability before within 60 days measured from the earlier latest of: the end of date on which the 18 month continuation periodSocial Security Administration issues the disability determination; and 60 days after the date the group health benefits would have otherwise ended; or the date the Qualified Continuee is determined to be disabledreceives the notice of COBRA continuation rights. If, during this extra 11 month continuation period, the Qualified Continuee is determined to be no longer disabled under the Social Security Act, he or she must notify the [Carrier] Employer within 31 30 days of such determination, and continuation will end, as explained in the When Continuation Ends section. An additional 50% of the total premium charge also may be required from the Qualified Continuee by the Employer during this extra 11 month continuation period. If An Employee Dies While Insured If an Employee dies while insured, any Qualified Continuee whose group health benefits would otherwise end may elect to continue such benefits. The continuation can last for up to 36 months, subject to the When Continuation Ends section. If An Employee's Marriage or Civil Union [or Domestic Partnership] Ends If an Employee's marriage ends due to legal divorce or legal separation or dissolution of the civil union [or termination of a domestic partnership], any Qualified Continuee whose group health benefits would otherwise end may elect to continue such benefits. The continuation can last for up to 36 months, subject to the When Continuation Ends section. If A Dependent Loses Eligibility If a Dependent child's group health benefits end due to his or her loss of dependent eligibility as defined in this Contract, other than the Employee's coverage ending, he or she may elect to continue such benefits benefits. However, such Dependent child must be a Qualified Continuee. The continuation can last for up to 36 months, subject to When Continuation Ends. The Employer's Responsibilities Upon loss of coverage due to termination of employment or reduction in work hours, the Employer must notify the former employee in writing, of: his or her right to continue this Contract's group health benefits; the monthly premium he or she must pay to continue such benefits; and the times and manner in which such monthly payments must be made. Upon being advised of the death of the Employee, divorce, dissolution of the civil union, [termination of domestic partnership] or Dependent child’s loss of eligibility, the Employer should notify the Qualified Continuee in writing, of: his or her right to continue this Contract's group health benefits; the monthly premium he or she must pay to continue such benefits; and the times and manner in which such monthly payments must be made.

Appears in 10 contracts

Samples: www.state.nj.us, www.nj.gov, www.nj.gov

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